The NHS crisis deepens as GP numbers dwindle

Telegraph View: Like so many problems afflicting the NHS, there is no
single cause for this problem.

One of the things this Government promised to do is tell us more about the actual state of the National Health Service. As a result, we are able to publish information today relating to GPs and the number of patients on their lists. The news is not encouraging, to put it mildly.

An increasingly serious shortage of GPs means that, on average, doctors in poorer and more-hard pressed parts of the South East see 2,000 patients each. In the inner cities, it is not unknown for a single doctor to accommodate 6,000 patients, though this can be done only by working dangerously long hours – dangerous for both doctor and patients. As Dr Michael Dixon, chairman of the NHS Alliance, admits, once the patient total exceeds 3,000, standards of care are hard to sustain.

Like so many problems afflicting the NHS, there is no single cause for this problem. The job of a GP has become far more bureaucratic since Labour’s health care reforms were introduced; doctors who are good at managing businesses and practise in a comfortable area can work the system to their benefit, earning very substantial salaries. But the old-fashioned GP with no managerial ambitions, who saw his or her job as being more akin to that of a local parish priest’s vocation, hates the paperwork and is only too glad to retire.

One significant demographic change has made matters worse. The generation of young doctors from India and Pakistan who arrived in Britain in the 1970s and 1980s and worked in our cities is reaching retirement; immigration restrictions mean they have not been replaced – and their jobs hold little appeal for today’s medical students, many of whom yearn instead to become hospital consultants in specialisations that are already over-subscribed.

Another factor is the increasing presence of women GPs. This is a welcome development in many ways; but surgeries are finding it hard to cope with the challenge of covering for women doctors during maternity leave. Other GPs, meanwhile, find that it suits them to spend only three days a week working in NHS general practice; that is their prerogative, but it all adds to the patchy nature of the service.

The new data have been published at an awkward time for the Coalition and for Andrew Lansley, the Health Secretary, whose NHS reforms are unpopular. But the truth must be faced. The familiar relationship that the British enjoyed with their GPs is beginning to die out. It can be rescued only by far-reaching and expensive measures to incentivise medical students to become full-time community doctors. Either that, or we will have to adjust to a more impersonal style of health care. As usual, there are no easy options.